Perinatal & Pediatric
Cognitive and behavioral scores at age 7 in relation to maternal mid-pregnancy plasma nutrient mixtures in a Singaporean family follow-up cohort Jordana Leader* Jordana Leader Damaskini Valvi Chai-Yang Chen Yap Seng Chong Kok Hian Tan Sharon Ng James Chun Yip Chan Johan G. Eriksson Mary Foong-Fong Chong Shiao-Yng Chan Jonathan Huang Youssef Oulhote
Background: Maternal nutrition during pregnancy has been shown to impact offspring’s health, especially neurodevelopment. While there is substantial research on individual nutrients such as folate, iron and vitamin D, little is known about the impact of mixtures of essential nutrients including both vitamins and minerals. This study explored the associations between mixtures of maternal essential minerals and vitamin concentrations and child behavior and cognition at age 7.
Methods: Data from 332 mother-child pairs in the Growing up in Singapore Towards healthy Outcomes birth cohort with both plasma nutrient and all neurodevelopmental outcome data were used. Mothers provided overnight fasting blood samples between 26 and 28 weeks of gestation. Plasma samples were analyzed for 10 essential minerals and 12 B and D vitamers. Child cognition and behavior functions at 7 years were assessed using the Wechsler Abbreviated Scale of Intelligence 2nd Edition (WASI-II) [n=331] and the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF-2) [n=332], respectively. Single nutrients were analyzed in association with BRIEF-2 and WASI-II index and composite scale T-scores using covariate-adjusted multivariable regressions. Grouped weighted quantile sum regression (gWQS) was used to investigate the associations of the nutrient mixture with child behavior and cognitive scores.
Results: A one unit increase in maternal sodium concentrations was associated with higher block design (β=1.54, 95% CI: 0.56, 2.53) and perceptual reasoning T-scores (β=1.49, 95% CI: 0.02, 2.95) as measured by the WASI-II. Additionally, a one unit increase in maternal concentrations of magnesium were associated with higher block design T-scores (β=1.10, 95% CI: 0.11, 2.09). When examining the mixture of the 22 nutrients, a one quartile increase of the nutrient mixture index composed of sodium, magnesium, vitamin B2-flavin, vitamin B2-neopterin, vitamin B3-nicotinamide, and vitamin D was associated with higher block design T-scores (β= 2.17, 95% CI: 0.03, 4.31). We found no associations with the BRIEF-2 T-scores.
Conclusions: In this study, we found that a mixture of maternal gestational minerals and vitamins, was associated with a greater ability in children to analyze and understand abstract visual items.